PCR diagnostics and monitoring of adenoviral infections in hematopoietic stem cell transplantation recipients

Abstract

After stem cell transplantation, human patients are prone to life-threatening opportunistic infections with a plethora of microorganisms. We report a retrospective study on 116 patients (98 children, 18 adults) who were transplanted in a pediatric bone marrow transplantation unit. Blood, urine and stool samples were collected and monitored for adenovirus (AdV) DNA using polymerase chain reaction (PCR) and real-time PCR (RT-PCR) on a regular basis. AdV DNA was detected in 52 (44.8%) patients, with mortality reaching 19% in this subgroup. Variables associated with adenovirus infection were transplantations from matched unrelated donors and older age of the recipient. An increased seasonal occurrence of adenoviral infections was observed in autumn and winter. Analysis of immune reconstitution showed a higher incidence of AdV infections during periods of low T-lymphocyte count. This study also showed a strong interaction between co-infections of AdV and BK polyomavirus in patients undergoing hematopoietic stem cell transplantations.

Incidence of Adenoviral DNAemia in Polish Adults Undergoing Allogeneic Haematopoietic Stem Cell Transplantation

“…Following HSCT, immunological responses to HAdV are poor; hence serological diagnosis is not reliable. Molecular identification of HAdV infection with PCR facilitates accurate and rapid diagnosis and can be used also for surveillance (Bil-Lula et al 2010;Ö hrmalm et al 2011). Weekly monitoring of different fluids of transplant recipients for active HAdV infection by real-time PCR (qPCR) could potentially be applied in HSCT recipients (Bil-Lula et al 2010;Matthes-Martin et al 2012).…”

“…Molecular identification of HAdV infection with PCR facilitates accurate and rapid diagnosis and can be used also for surveillance (Bil-Lula et al 2010;Ö hrmalm et al 2011). Weekly monitoring of different fluids of transplant recipients for active HAdV infection by real-time PCR (qPCR) could potentially be applied in HSCT recipients (Bil-Lula et al 2010;Matthes-Martin et al 2012). Treatment of HAdV infection using ribavirin and/or cidofovir has not been proven in controlled trials yet, and their administration is limited by toxicity in adults (Lenaerts and Naesens 2006;Matthes-Martin et al 2012).…”

Investigation of Cytomegalovirus, Epstein-Barr Virus and Adenovirus Infections After Hematopoietic Stem Cell Transplantation (HSCT) in Pediatric Patients

“…HKHT alı-cılarında ADV infeksiyonu insidansı %5 ile %32 arasında bildirilmiştir [13] . Çocuklarda ADV özellikle pnömoni ve hepatite sebep olur ve mortalite oranı %10-80'e kadar yüksek olabilir [14] . Kanda CMV, ADV ve EBV viral yükleri yükseldiğinde preemptif tedavi olarak antiviral ilaç tedavisi ve immünsüpresyonun azaltılması uygulanır.…”

Disseminated Adenovirus Disease in Immunocompromised Patient Successfully Treated with Oral Ribavirin: A Case Report

“…In these situations, qPCR assay became very useful tool for the rapid, specific, and sensitive detection of HAdVs in different kind of samples (Bil-Lula et al 2010b). In addition to the promptness of detection, determination of the viral load is valuable because it may have predictive value for disseminated adenoviral disease (Claas et al 2005;Lion et al 2003).…”

“…Quantitative or semiquantitative PCR assays allow also monitoring of the kinetics of the viral infection or effectiveness of antiviral treatment (Claas et al 2005). Quantification of HAdV DNA load has been suggested especially in patients who are at the greatest risk of dying from disseminated adenoviral infection (Bil-Lula et al 2010b;Claas et al 2005;Lion et al 2003), but treatment strategies supported with quantitative results of virus load monitoring with real-time PCR have not been validated by clinical trials so far.…”